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Managing pain in children

Children will experience pain regularly. They fall over, they get an earache and they cut new teeth. Often, they’ll have a sharp acute experience of pain which, thanks to our clever brains will subside, and the kids will get better.

Sure there’ll be tears and possibly a bit of screaming. But a bit of appropriately applied TLC from Mum or Dad (more on this later), and your child will be up and running around again before you know it – and may have developed a good response and attitude to pain which they can use next time they fall over.

But sometimes pain in children needs more management – and, according to many, many studies and experts, parents play a pivotal role in how children deal with pain at the time, and in subsequent incidents.

Understanding childhood pain

It’s undeniable now that that infants, and children of all ages, have the capacity to perceive pain. And what many researchers in this area now know is that children are more sensitive to pain than adults – that is they feel it more intensely.

The types of pain kids can experience during their childhood include:

Everyday pain: These are the minor bumps, bruises and scrapes which are part of being a kid. They are usually not serious, but each episode provides an opportunity for kids to learn about avoiding danger as well as builds on their attitudes to coping with pain.

Short-term pain: This can last minutes, hours or days and includes pain from illness, injury and immunisations. Again, these experiences can have a big impact on how children deal with pain going forward.

Recurrent pain: This type of pain, stomach-aches, headaches, growing pains and back pain, is estimated to be experienced occasionally to frequently by about 30% of children. While it’s often hard to find actually medical or pathological reasons for these pains, it’s worth remembering that the pain is real and should not be trivialised.

Chronic pain: This is any pain which lasts more than three months, and can accompany childhood disease and injury. It is understandably a difficult type of pain to treat and manage in children.

Recognising it hurts

According to Professor David Champion, founder and director of the Sydney Children’s Hospital’s Pain Research Unit, parents are very good at knowing if their child is in pain.

“They are aware of their child’s behaviours and will recognise then changes which could indicate that their infant or child is uncomfortable or in pain,” he says. “If a parent believes their child is pain, they’re often right.”

But it can be difficult to spot still if a child is unable to communicate effectively. Basically, across all ages parents are encouraged to note changes in eating, sleeping, crying or movement.

Parents’ crucial role

Parents are not only invaluable in helping detect pain in their children but also in helping their child manage and deal with pain.

“How a parent reacts to their child about pain that’s about to happen – like an immunisation – or a painful incident that has occurred will have an enormous impact on how that child reacts and deal with that pain,” Professor Champion says.

He says that overly reassuring parents will actually make worse the pain experience for their children. “Study after study has shown that when parents excessively console their child, the pain will take longer to settle down,” he says.

He urges parents instead to be “calm and matter-of-fact” when dealing and managing their child’s pain. “Of course, respond promptly and practically and acknowledge that it hurts, but don’t be apologetic or catastrophise the situation – that will not help the child. This may seem counter-intuitive to many parents today but it is backed by research,” Professor Champion says.

A 2009 study confirmed that children’s distress during painful medical procedures is strongly influenced by adult behaviour. It found that adult reassurance increased child distress whereas distraction improved how the child coped.

The researchers also found that facial expressions used by overly reassuring parents conveyed fear, while the associated talking in a rising tone exacerbated that fear.

The bottom line is, according to many experts in the field of child pain, to always remember that pain is what a child says it is, and parents and health professionals need to believe it as fact. Good pain relief, positive attitudes and keeping them feeling comfortable and supported will allow them to put their full energy into healing, getting well and feeling better.

Seeking specialist advice

There are analgesics and other medications which help treat and relieve pain. And there are many drug-free methods which have been found to be very successful in helping children manage pain, but if your child is in any pain it should be dealt with.

Most minor injuries, bruisings and scrapes can be handled at home. Parents would know when to seek help.

But a doctor should be consulted about unexplained pains, or those associated with illness or fever or what could be a more serious injury (like a broken bone).

Children who suffer recurrent or chronic pain, and their parents, can also benefit from seeking advice on how they can learn to deal and manage their own pain.

Here are some words of wisdom from internationally renowned pain expert, clinical psychologist Dr Leora Kuttner, author of A Child in Pain: How to Help, What to do: “… use the minor pains of everyday life as opportunities to train a child to become ‘pain-literate’. (This) means the child can interpret the pain signal intelligently rather than being overwhelmed by the fear of pain and accept support and be willing to help in letting the pain go.”